Mindful eating found to help diabetics

I believe I eat a generally healthy diet, but I’m no angel. One of my weaknesses is my ‘speed eating’ – a tendency to consume food too quickly and a failure to savour it properly. One of the risks of eating this way is that it can bypass some of the body’s natural cues regarding satiety, and therefore lead us to eating more than we need. This is one of the reasons why I have, in the past, recommended ‘mindful eating’ for those seeking to control their food consumption and their weight.

I was therefore interested to read today about a study in which mindful eating was trialled in a group of individuals with type 2 diabetes [1]. You can read about the study here. Basically, though, individuals were instructed in the art and practice of mindful eating through group sessions spanning a 3-month period. This instruction involved encouraging people to tune into their body before eating and taking a few moments to assess their level of hunger. They were also encouraged to make conscious choices about how much they would eat, as well as stopping eating once they were full.

Results in this group were compared with those in individuals who were not instructed in mindful eating, but instead were given standard nutrition advice as dispensed during conventional diabetes education programmes.

Both interventions led to improvements in weight (the standard and mindful approaches led to losses of about 3 and 1.5 kg respectively). More impressive, though, was the reduction in a marker of blood sugar control known as HbA1c (which measures overall blood sugar control over the last 3 months or so). This fell by about 0.7 and 0.8 per cent in the standard and mindful group respectively. This is the sort of reduction (improvement) one expects to see through the addition of a diabetes medication.

My experience in practice tells me that quite a lot of self-confessed over-eaters are victims of habit and conditioning. If you feel this may be true for you, here’s a few things that might help:

1. Get in tune with your hunger signals
Spend just a few seconds, several times each day, asking yourself just how hungry you really are. Rate your hunger on a scale of 0–10. Just doing this will help you get back in touch with the signals your body uses to tell you how genuinely hungry you are.

2. Avoid eating ‘by the clock’
Some individuals get themselves into the habit of ‘eating by the clock’, for example having lunch because it’s ‘lunch time’ whether hungry or not. If you are aware that you do this resolve, wherever practical, to delay eating until genuine hunger is present.

3. Avoid ‘clearing your plate’
One potential driver of unnecessary eating that is the belief that we need to finish everything on our plate. A common cause of this is messages received in childhood about the importance of not wasting food, particularly in light of the plight of starving children in the Third World. Yet, in reality, the eating of more than you need to in no way helps starving children (or anyone else). Being mindful of this can be all that it takes to rid yourself of a ‘clear the plate’ mentality.

4. Use smaller crockery
A meal that’s big enough to truly satisfy may still look insignificant or ‘lost’ on a large plate or in a big bowl. Using crockery that is appropriate for smaller-sized but properly satisfying meals can reduce the tendency to pile food unnecessarily high.

5. Avoid ‘eating for later’
Some individuals eat with a goal of avoiding hunger before the next meal. However, this can encourage overeating when the time between meals is long (e.g. between lunch and dinner). Aim to eat enough at each meal to be comfortably full. Remember it’s perfectly fine to eat a healthy snack (e.g. nuts) to tide you over to the next meal should you get peckish.

References:

1. Miller CK, et al. Comparative Effectiveness of a Mindful Eating Intervention to a Diabetes Self-Management Intervention among Adults with Type 2 Diabetes: A Pilot Study. Journal of the Academy of Nutrition and Dietetics. 2012;112(11):1835

12 Responses to Mindful eating found to help diabetics

Hi John,
The people with the standard diabetes education programme advice did marginally better than those with the mindful eating advice. Did they get the standard diabetesUK/Government advice or were they told to eat fewer carbs?

I am not ‘mindful’ but do use a few tricks along the lines you suggest.

1) smaller plate (as you suggest)
2) smaller fork (salad fork even for main dishes
3) small spoonfuls when eating dessert. I think psychologically we feel happier per individual taste event so dividing a given quantity into more portions is more rewarding.
4) Use chopsticks for especially compelling foods like my wife’s wonderful keema or sunflower seeds.

Essentially we don’t need as much food as we often think we do. I find that eating a light breakfast and dinner suffice for me. I’m not hungry at other times although I’m aware thaat i might get “the munchies”
Hana

Although I agree that these methods can be helpful, people with a form of food-induced brain dysfunction called CARB syndrome might not benefit too much unless their disease is properly treated. Their normal mechanisms for controlling eating are totally out of sync. They are often truly hungry shortly after eating a meal and they always have craving for sweet and starchy food. As far as hunger goes, they don’t know if they are on foot or horseback.

This disease appears to be triggered by long-term exposure to excessive fructose mainly from sugar and HFCS and high glycemic carbohydrates mainly from grains. In my experience mindful eating is most useful for people with normal brain function.

As you point out in your books, L-glutamine taken as a supplement is one way to knock down excessive hunger, especially carbohydrate cravings. Because people with CARB syndrome tend to have low levels of monoamine neurotransmitters, supplements containing L-tyrosine and 5-HTP in a ratio of 10 to 1 can also be helpful at controlling hunger and cravings.

It’s amazing how so often we spend so much time thinking about food and then don’t pay attention or savour our food while we’re eating it. If we can learn to enjoy our food more we can find that we enjoy it more, and are more satisfied with our food and therefore eat less.

I made a few attempts at mindful eating while on SAD, and I have to say it did NOT help. On SAD, because the food was nutritionally void and constantly spiking my blood glucose/insulin levels, I was constantly hungry. All mindfulness did was make me perceive the hunger even more acutely. I couldn’t stop when satisfied because I was NEVER satisfied.

On a LCHF diet, I’m very satisfied. I take and eat small amounts, and I almost never feel hungry. Instead of feeling bloated, uncomfortable, vaguely hungry and slightly panicked (how long until the next meal?), I feel calm, comfortable and satisfied now.

Seriously, those suggestions like eat from a smaller plate appear in women’s magazines all the time, along with the recipes for double fudge banana nut brownies. They simply do not work when your body needs nutritionally dense foods that provide satiety and don’t spike your blood sugar.

Since following a LCHF diet from 2007 Hunger isnt one of the things i actually suffer with.
My problem now is more the other way, Actually finishing the meal. I tend to get a very full up feeling or loss of appetite often before the end of the meal however tasty and enjoyable.
I would say that i now eat about 50% less in any meal than i did pre 2007.

I agree with Janknitz that if your on a low carb/Paleo diet it’s a lot easier to be “mindful” when eating.

I have eaten Paleo for 6 years and it can still sometimes be possible to overeat but for me I find drinking a pint of water before and during a meal helps me to not overeat. It also helps make me eat slower thus, enjoying my food more.

Also, it is sometimes difficult to not finish your plate even when your full. So, I like to put the veg/salad (sometimes meat/fish) in the middle of the table so I can dish a small amount on my plate at a time and easily go back for more if still hungry. I guess it is still possible to overeat this way but sharing the food with others makes you more mindful of taking more than your fair share:)

“Essentially we don’t need as much food as we often think we do.”
I so agree. I have thought for some time that recommended calorie levels err on the side of more rather than optimal. When you look at the history of the “calorie” and the subsequent setting of the recommended intake it’s hard to believe that there is a scientific basis for it, rather like the 5 a day or the 14/21 units! People are so different in size, activity and lifestyle how could the calorie total fit everyone?

As for eating more slowly, interesting but I’m not sure how relevant. Husband has been overweight for years and has Type ll. I have been overweight for years and don’t. He eats at an unbelievable speed and finishes first no matter what is on his plate. I eat at snail’s pace and am always the last to finish.

In latter years, especially the last 7 months or so, we have both been trying the low carb. diet as recommended by Dr. John and have incorporated the fasting regime as suggested on the Horizon programme. We have crept down the weight ladder, both of us have pretty much lost a stone. We definitely eat much less than we have ever done. At this point, I am bemused, by my reckoning we should both be at least a couple of stone lighter but we aren’t?

Something else is missing from the equation (please don’t suggest exercise, we take about 1 hour a day walking) but I’m with Dr. B. in as much as unless you exercise like an athlete, you aren’t going to make a lot of difference to your weight loss. Are we still eating too much? We must be I guess. How low can you go before you aren’t eating enough though?

I have a son, who is four and has type 1 diabetes(diagnosed when eighteen months).
We are advised to give him a balanced diet, including grains e.g. bread,crackers,cereal,oats,pasta and rice (Brown and white)- to fill him up and give him the energy he requires; and then he obviously needs insulin to counter that. He used to love porridge,(although since this brings about a spike in his blood sugar level I have switched to 20g of All Bran, which gives a much better reading,usually <10.), so by mid morning can be a high as 18!- but by lunch be 5.0.
He has a wonderful appeitite and loves most foods, including chicken,meat, fish, vegetables,particularly carrots, with houmous, and has cheese and milk, berries, bananas,avocado even ginger and garlic. For a four year old he is pretty amazing.
In your medical opinion, would a diet without the 'grains' above be of benefit, to him and give him all the energy he requires, and enough vitamins/proteins to grow and be healthy?
His HbA1c is 7.6mmol, and his weight is 18.85kg-height 106cm.
I would be really interested for your opinion.
Many thanks- you were referred to me by Monique Palmer who I recently met a party where far too many grains were consumed, accompanied by many cups of tea!

Julia
It’s over a year since your posting I am well aware
I just stumbled across this site
I hope your son is doing well
I am health care professional with type one diabetes. I am somewhat disturbed that the NHS is still promoting a high carb diet or at least stating that starchy carbs should be consumed with every meal
For some people with diabetes which is hard to manage- or those who struggle to keep their weight down, this is a not particularly helpful strategy
The problem I believe is that some dieticians are brainwashed – eg. stating that low carb diets are unhealthy because they exclude adequate quantities of fruit and vegetables (‘scuse me- but if you are cutting down on spuds and pasta surely you will compensate with more salad and leafy veg) and a few minutes later stating that green leafy veg do not contain carbohydrate- so all rationality flies out of the window
As a person with type one I hope that your son is on a basal bolus regimen and able to delay or skip meals if wished- and within reason to adjust for meals with differing quantities of carbohydrate. However, moderation of carbs and choosing lower GI versions is often helpful to maintain good control of blood sugar levels
I currently do not follow a low carbohydrate eating plan generally but if blood glucose is running high or I am particularly inactive I find filling my bowl with salad and minimising starchy food is helpful. On the other hand activities such as strenuous walking, digging the garden etc mean heavy carb consumption can be enjoyed while maintaining good control
I think the current healthy eating guidelines and “eat well” plate are a throwback from the 1940s and 50s when people were far more physically active ( cars rare, more manual jobs, housework far more demanding etc)

As an aside mindful eating is something we should probably all be adopting ( I know I’m guilty of bolting my food down) but many people with diabetes are on regimens with either sulphonylurea drugs or premixed insulins which result in their mealtimes being dictated regardless of whether eating at that time is predictable or desirable to them

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